Text Book Review Odem Otak Pada Pasien Stroke Iskemik Akut

Text Book Review

Odem Otak Pada Pasien Stroke Iskemik Akut

Pembimbingdr. Muttaqien Pramudigdo, Sp. S

Disusun olehHandiana SamantaG1A013062

Pendahuluan Etiologi Klasifikasi

Odem sitotoksik vs vasogenikPatomekanisme

Patomekanisme Patomekanisme Glukosa re-uptake ATP menurunPelepasan glukosa glukosa Aktivasi r-NMDAAir masuk Na2+ intraselulerOdem otakGlikolisis anaerob meningkatDepolarisasi neuronalVSCC membukaCa2+ intraseluler meningkatKegagalan energihipoksiaO2 dan glukosa jaringan otak menurunPatomekanisme hipoksiaeNOSnNOSiNOSO2H2O2sitokinONOONO2, NO3Pro-MMPMMP-1MMP-2MMP-9MAPKAP-1NF-KPARPOccludinCadherinClaudin Gangguan permeabilitasPatomekanisme Jv (flow)= Lp (Pplasma-Ptissue)- (Pplasma -Ptissue)

Lp adalah penghantar hidrolik dari sawar darah otak; Pplasma-Ptissue adalah tekanan hidrostatik intravaskular dan jaringan otak; Pplasma dan Ptissue adalah tekanan osmotik intravaskular dan jaringan otak, dan adalah koefisien refleksi osmotikOdem otak dapat disebabkan beberapa kelainan, yaitu:a. peningkatan tekanan kapiler otak (Pplasma, kekuatan hidrostatik) dengan asumsi adanya stabilitas tekanan interstisial (Ptissue)b. peningkatan permeabilitas air (koefisien filtrasi kapiler, Lp)c. peningkatan permeabilitas protein (penurunan ) dengan asumsi bahwa perubahan yang tidak berarti pada onkotik gradient antara kapiler dengan interstitial (Pplasma-Ptissue) (11).

Patomekanisme

Prediktor Klinis dan Radiologis Komplikasi Gold Standart

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